Is an Emergency Room Visit Needed? An uncomplicated convulsive seizure in someone who has For Law Enforcement Officers: Epilepsy And Drugs Could It Be Epilepsy? Autism, Epilepsy Epilepsy is not a medical emergency, even though it looks like one. It stops naturally after a few minutes without ill effects. The average person is able to continue about his Despite medical progress, Epilepsy cannot be cured in the same sense that an infection can be cured. However, Only a physician can say for certain whether or not a person has Epilepsy. Many people miss the more subtle signs of the condition and therefore also miss & Seizures: business after a rest period, and may need only limited seizures can be controlled completely or significantly the opportunity for early diagnosis and treatment. The How to Recognize the Signs and symptoms listed below are not necessarily indicators of assistance, or no assistance at all, in getting home. reduced in most people who have the disorder. This Epilepsy, and may be caused by some other, unrelated Basic First Aid When You Do However, occasionally a seizure will fail to stop naturally control is achieved through regular, daily use of condition. However, if one or more is present, a and as noted earlier, there are several medical conditions antiseizure drugs called anticonvulsants. Doses may medical check-up is recommended. other than Epilepsy that can cause seizures. These include: have to be taken up to four times a day, and people with Epilepsy therefore usually carry medication with them. Periods of blackout or confused memory. Diabetes poisoning brain infections To miss a scheduled dose is to risk a seizure. Occasional “fainting spells” in which bladder or bowel hypoglycemia heat exhaustion high fever Many medications are used in the treatment of Epilepsy. control is lost, followed by extreme fatigue. pregnancy head injury More than one drug may be prescribed. Among them phenobarbital, Ativan (lorazepan), Klonopin Episodes of blank staring in children; brief periods (clonazepam), Tranxene (clorazepate) and Valium when there’s no response to questions or instructions. When seizures are continuous or any of these conditions (diazepam). Sudden falls in a child for no apparent reason. exist, immediate medical attention is necessary. If a law enforcement officer has any doubts about the Episodes of blinking or chewing at The following are some suggestions to help people with Epilepsy legality of a person’s possession of medication, the inappropriate times. avoid unnecessary trips to the emergency room and help one de- physician who prescribed the drug, or the pharmacy cide whether or not to call an ambulance. One should not rely on A convulsion, with or without fever. that dispensed it, should be contacted without delay. this general information as individual cases may vary, therefore a Depriving a person with Epilepsy of access to her Clusters of swift jerking movements in babies. physician should always be consulted in all emergencies. medication may put her health and life at risk. No Need to Call An Ambulance When medication is taken away, for even as little as several hours, the following may happen: If medical I.D. jewelry or card says “Epilepsy,” and If the seizure ends in under five minutes, and A convulsive seizure with subsequent injury due to If consciousness returns without further incident, and falling on cement floors, or in a confined area. If there are no signs of injury, physical distress, or pregnancy. A series of convulsive seizures called status epilepticus, in which the convulsions continue An Ambulance Should Be Called non-stop, or are followed by coma or a subsequent series of seizures. These are life threatening, and the If the seizure has happened in water. mortality risk is high unless prompt treatment at If there’s no medical I.D., and no way of knowing a properly equipped medical facility is available. whether the seizure is caused by Epilepsy. Episodes of automatic behavior, known as complex If the person is pregnant, injured, or diabetic. partial seizures, in which the person, unaware of If the seizure continues for more than five minutes. where he is or what his circumstances are, injures himself in unconscious efforts to escape, or is injured If a second seizure starts shortly after the first has ended. in struggles with law enforcement personnel. A in collaboration with If consciousness does not start to return after the person having this type of seizure is on automatic shaking has stopped. pilot so far as his actions are concerned. Efforts to If the ambulance arrives after consciousness has returned, restrain can produce a fighting reaction which he 609-392-4900 the person should be asked whether the seizure was cannot control. Dr. Ruth Nass associated with Epilepsy and whether emergency room care is wanted. The purpose of this informational brochure is to offer general Network determined that 1 in 150 children are The risk of Epilepsy is low, about 2% by 5 years and 10% First Aid for Seizures in information on Autism and Epilepsy and the co-condition as diagnosed with an Autism in the United States. In by 10 years, for those with Autism who do not have intel- well as the types of seizures and basic first aid recommended by some states the diagnosis is more prevalent. lectual and developmental disabilities or Cerebral Palsy. Special Circumstances the Epilepsy Foundation.* One should not rely on this general information as individual cases may vary. It is recommended Autism is a lifespan challenge and most individuals, Individuals with both Autism and Epilepsy have a Although the fold-out chart inside this brochure gives that one’s physician should always be consulted on all including those with Asperger Syndrome, will require more challenged developmental trajectory than those information on basic first aid for a generalized tonic clonic some sort of support and services throughout their lifetime. with either Autism or Epilepsy alone. (convulsive) seizure, there are some special circumstances in information provided here as a public service. which additional steps should be taken. One should not rely on * This information is taken from Seizure Recognition and First Aid, a publication Individuals with Autism are capable of participating Individuals with Autism and severe intellectual and this general information as individual cases may vary, therefore a of the Epilepsy Foundation. developmental disabilities have a risk of acquiring Epilepsy in community life and can live, work and recreate in physician should always be consulted on all first aid procedures. community settings with the proper support. of 5% at 1 year, 15% at 5 years, and 25% at 10 years. Facts About Autism Individuals with Autism and both intellectual and de- A seizure in water Individuals with Autism have diverse talents and abilities and can contribute to society in suitable and velopmental disabilities and Cerebral Palsy have a risk If a seizure occurs in water, the person should be Autism affects each individual in a different manner of acquiring Epilepsy of 20% at 1 year, 35% at 5 years, supported in the water with the head tilted so his face sustainable endeavors. but is generally characterized by impairments in social and 65% at 10 years. and head stay above the surface. He should be removed interactions and communication skills. In some people, from the water as quickly as possible with the head in Epilepsy persists in the majority of patients into adult Autism also affects cognitive, emotional and behavioral Facts About Epilepsy life with remission in only 15% of adults with Autism this position. Once on dry land, he should be examined functioning. People with Asperger Syndrome (also and, if he is not breathing, artificial respiration should and Epilepsy. know as high functioning Autism) may have superior Epilepsy is defined as a tendency toward recurrent be begun at once. Anyone who has a seizure in water skills and intelligence. seizures unprovoked by any systematic or acute Epilepsy and Autism may reflect the same underlying should be taken to an emergency room for a careful neurologic insults. brain abnormality and there are many disorders such medical checkup, even if he appears to be fully recovered Autism is four times more prevalent in boys than girls. as Fragile X, Tuberous Sclerosis and Down Syndrome A seizure is the manifestation of abnormal electrical afterwards. Heart or lung damage from ingestion of water No one is sure what causes Autism but studies of twins where Autism and Epilepsy may co-occur on this basis. activity in the brain. is a possible hazard in such cases. reveal that it is potentially a genetically based condition. In identical twins there is an 80-90% chance that each The highest incidence of a first seizure occurs in A seizure in an airplane will have Autism and in non-identical twins there is individuals under 20 years old. Types of Seizures a 3-10% chance that both will develop Autism. The If the plane is not filled, and if the seat arms can be folded In 2008, the CDC reported that 2.7 million Americans Seizure disorders take several forms, depending on where in up, passengers to the left and/or right of the affected chance that siblings will both be affected by Autism is have Epilepsy and that Epilepsy affects 1 in 100 adults. the brain the malfunction takes place and how much of the person may be reassigned to other seats, so that the person also approximately 3-10%. There are different types of seizures that are manifested total brain area is involved. having the seizure can be helped to lie across two or more Early signs of Autism may include lack of social interaction, seats with head and body turned on one side. by a variety of symptoms. Generalized tonic clonic seizure: These are the ones communication, and inappropriate behavior. Autism’s early signs may be detected in infants as young as 6-18 Seizures can be diagnosed by electroencephalogram which most people generally think of when they hear the Once consciousness has fully returned, the person can be months and is often reported by parents who are concerned known as an “EEG” which is a recording of electrical word “Epilepsy.” helped into a resting position in a single reclining seat. that their child fixates on objects, does not respond to activity in the brain. In this type of seizure the person undergoes convulsions If there are no empty seats, the seat in which the person their name, avoids eye contact and engages in repetitive Medications are available to help individuals control which usually last from two to five minutes, with complete is sitting can be reclined, and, once the rigidity phase has movements such as rocking or arm flapping. Parents who loss of consciousness and muscle spasms. passed, he can be turned gently while in the seat so that seizures and in some cases may be reduced or notice such signs or are concerned that their child is not Absence seizure: Takes the form of a blank stare lasting he is leaning towards one side. discontinued as a person ages. meeting developmental milestones, should contact their only a few seconds. pediatrician and arrange for a developmental screening. Individuals with Epilepsy can lead full and productive Pillows or blankets can be arranged so that the head lives with proper treatment and monitoring. Partial seizure: Produces involuntary movements of arm or doesn’t hit unpadded areas of the plane. However, care Scientists agree that early intervention services can leg, distorted sensations, or a period of automatic movement should be taken that the angle at which the person is increase chances for a child’s positive prognosis. in which awareness is blurred or completely absent. sitting is such that his airway stays clear and breathing Children with Autism can benefit from known effective Epilepsy and Autism: The Co-Condition is unobstructed. treatments such as applied behavior analysis (ABA), Since these seizure disorders are so different in their effects, occupational, speech and physical therapy. Other they require different kinds of action from the public. Some A seizure on a bus As many as one-third of individuals with Autism also require no action at all. The fold-out section of this brochure treatments touted on the internet and in the media Ease the person across a double or triple seat. Turn him have Epilepsy. describes seizures in detail, and how to handle each type. It may not be backed by science and should be cautiously on his side, and follow the same steps as indicated above. Two peaks of onset: infancy and adolescence. has been produced in this form to encourage posting on staff pursued as they may cause harmful side effects. If he wishes to do so, there is no reason why a person who bulletin boards or other places where it can be easily seen, for In 2007, the Center for Control and Prevention’s example, by caregivers, first-responders, and by those who has fully recovered from a seizure cannot stay on the bus Autism and Developmental Disabilities Monitoring work with individuals who have Autism and/or Epilepsy. until he arrives at his destination. Autism, Epilepsy & Seizures: in collaboration with Dr. Ruth Nass How to Recognize the Signs and Basic First Aid When You Do 609-392-4900 This information is taken from Seizure Recognition and First Aid, a publication of the Epilepsy Foundation. SEIZURE TYPE WHAT IT LOOKS LIKE WHAT IT IS NOT WHAT TO DO WHAT NOT TO DO Generalized Sudden cry, fall, rigidity, followed by muscle jerks, shallow breathing or temporarily Heart attack. Stroke. Look for medical identification. Protect from nearby hazards. Don’t put anything in the mouth. Don’t try to hold tongue. It can’t be suspended breathing, bluish skin, possible loss of Tonic Clonic bladder or bowel control, usually lasts a couple of minutes. Normal breathing then starts again. Loosen ties or shirt collars. swallowed. Don’t try to give liquids during or (Also called Grand Mal) There may be some confusion and/or fatigue, Protect head from injury. just after seizure. followed by return to full consciousness. Turn on side to keep airway clear unless injury exists. Reassure as consciousness returns. Don’t use artificial respiration unless breathing is absent after muscle If single seizure lasted less than 5 minutes, ask if jerks subside. hospital evaluation wanted. Don’t restrain. If multiple seizures, or if one seizure lasts longer than 5 minutes, call an ambulance. If person is pregnant, injured, or diabetic, call for aid at once. Absence A blank stare, beginning and ending abruptly, lasting only a few seconds, most common in Daydreaming. Lack of attention. No first aid necessary, but if this is the first observation of a seizure, medical evaluation is (Also called Petit Mal) children. May be accompanied by rapid blinking, Deliberately ignoring adult recommended. some chewing movements of the mouth, Child or adult is unaware of what’s going on during instructions. the seizure, but quickly returns to full awareness once it has stopped. May result in learning difficulties if not recognized and treated. Simple Partial Jerking may begin in one area of body, arm, leg, or face. Can’t be stopped, but patient stays awake Acting out, bizarre behavior. Hysteria. No first aid necessary unless seizure becomes convulsive, then first aid as above. and aware. Jerking may proceed from one area of No immediate action needed other than the body to another, and sometimes spreads to Mental illness. reassurance and emotional support. become a generalized convulsive seizure. Psychosomatic illness. Medical evaluation is recommended. Parapsychological or mystical experience. Complex Partial Usually starts with blank stare, followed by chewing, followed by random activity. Person Drunkenness. Intoxication on drugs. Speak calmly and reassuringly to patient and others. Don’t grab hold unless sudden danger (such as a cliff edge or an (Also called Psychomotor appears unaware of surroundings, may seem dazed Mental illness. Guide gently away from obvious hazards. approaching car) threatens. and mumble. Unresponsive. Actions clumsy, not or Temporal Lobe) directed. May pick at clothing, pick up objects, Disorderly conduct. Stay with person until completely aware of Don’t try to restrain. try to take clothes off. May run, appear afraid. environment. Don’t shout. May struggle or flail at restraint. Once pattern Offer to help getting home. Don’t expect verbal instructions to established, same set of actions usually occur be obeyed. with each seizure. Lasts a few minutes, but post- seizure confusion can last substantially longer. No memory of what happened during seizure period. Atonic Seizures A child or adult suddenly collapses and falls, After 10 seconds to a minute he recovers, regains Clumsiness. Normal childhood “stage.” No first aid needed, unless the person was hurt upon falling. (Also called Drop Attacks) consciousness, and can stand and walk again. In a child, lack of good Medical evaluation is recommended. walking skills. In an adult, drunkenness, acute illness. Myoclonic Sudden brief, massive muscle jerks that may involve the whole body or parts of the body. May Clumsiness Poor coordination. No first aid needed, but medical evaluation is recommended. cause person to spill what they were holding or Seizures fall off a chair. Infantile These are clusters of quick, sudden movements that start between 3 months and two years. If a Normal movements of the baby. No first aid needed, but medical evaluation is recommended. child is sitting up, the head will fall forward, and Spasms the arms will flex forward. If lying down, the knees will be drawn up, with arms and bead flexed Colic. forward as if the baby is reaching for support.